Serial night casting increases ankle dorsiflexion range in children + young adul

[Guest guest]

J Physiother. 2010;56(2):113-9.

Serial night casting increases ankle dorsiflexion range in children and young

adults with Charcot-Marie-Tooth disease: a randomised trial.

Rose KJ, J, Refshauge K, North KN, Burns J.

Institute for Neuroscience and Muscle Research, The Children's Hospital at

Westmead, Westmead, NSW, 2145, Australia. Kristy2@....

Abstract

Question: Does 4 weeks of serial night casting followed by 4 weeks of stretching

of the gastrocnemius and soleus improve ankle dorsiflexion range and other

outcomes compared with no intervention in children and young adults with

Charcot-Marie-Tooth disease?

Design: Randomised trial with concealed allocation, assessor blinding, and

intention-to-treat analysis.

Participants: 30 children and young adults with Charcot-Marie-Tooth disease and

restricted ankle dorsiflexion range.

Intervention: The experimental group received 4 weeks of serial night casting

followed by 4 weeks of weightbearing stretches. The control group received no

intervention. Outcome measures: Primary outcome was ankle dorsiflexion range;

secondary outcomes included foot deformity, mobility, balance, falls, and

self-reported activity limitations. Outcomes were measured at baseline, 4, and 8

weeks.

Results: By 4 weeks, serial night casting had increased ankle dorsiflexion range

by a mean of 4 deg (95% CI 2 to 6) more in the experimental group than the

control group. After a further 4 weeks of weightbearing stretches, the

experimental group still had a mean of 3 deg (95% CI 0 to 5) more ankle

dorsiflexion range than the control group. Other than reduced time to walk 10

metres at self-selected pace favouring night casting at 4 weeks, outcomes did

not differ between groups at any time point. Two minor adverse events were

reported in the experimental group.

Conclusion: 4 weeks of serial night casting increased ankle dorsiflexion range

compared with no intervention, but at 8 weeks there was no significant

difference between groups.